Introduction 

ears ago, I watched my own mother go through arthritis pain that slowly became arthrosis or degeneration of the joints of her fingers then of her hips, necessitating a painful left hip replacement.  Things then transferred to the opposite side.  The initial suggestion was a knee replacement followed by another hip replacement.  She was deeply traumatized by the experience and the invasive nature of the intervention and decided against the second replacement. 

The treatment of choice some 30 years ago was acetaminophen or Tylenol.  After decades of research and billions of dollars donated to various foundations, the treatment of choice 30 years later is still acetaminophen or its close derivatives. 

y Mother suffered from various liver related problems as well as digestive problems and digestive system ulcerations. Did it dawn on her that these adverse effects could be caused by her medication?  Her medical doctor of the time didn't think so, as it was a very widely used and trusted medication.  In hind sight (she passed in 1999), the latest information suggests that the FDA has long been aware of studies showing the risks of acetaminophen.  So has the maker of Tylenol. , McNeil Consumer Healthcare, a division of Johnson & Johnson" and "McNeil, the maker of Tylenol ... has repeatedly opposed safety warnings, dosage restrictions and other measures meant to safeguard users of the drug." Acetaminophen, including Tylenol, causes three times as many cases of liver failure as all other drugs combined and is the most common cause of acute liver failure in North America accounting for 39% of cases. (^  Drug-Induced Hepatotoxicity, William M. Lee, New England Journal of Medicine, July 31, 2003, 349:474-485)  

his American Life reported that "acetaminophen, the active ingredient in Tylenol ... kills the most people [of any over-the-counter drug], according to data from the federal government. Over 150 Americans die each year". This assessment conflicts with assessments in the medical literature, which suggest that the most commonly used alternative to acetaminophen, non-steroidal anti-inflammatory drugs (including naproxen, ibuprofen, and aspirin) cause 3200 deaths and 32,000 hospitalizations each year due to gastric bleeding alone Other estimates place the number of NSAID-related deaths from gastric bleeding as high as 16,000 per year.  The apparent discrepancy may arise because the PBS assessment relied exclusively on reports from poison control centers. Such centers are unlikely to report gastric bleeding episodes as NSAID-related, as such episodes may be caused by factors other than NSAID use, and are associated more closely with chronic use rather than acute overdose. 

ack in the 80's, advertising that medical doctors relied on, Tylenol emphasized that it is the drug that American hospitals trust the most. In this ad, Susan Sullivan   told the consumer that Tylenol was a drug that could be trusted by Americans since many doctors also trusted it; she went on to state that doctors prescribed Tylenol four times more often than the other leading pain relieving drugs combined.  It is time to move on.